CAJ | 학술논문

目的：对比研究脊髓型颈椎病三种不同手术方法的临床疗效。方法自2011年9月至2013年9月共收治85例脊髓型颈椎病患者，分为 A、B、C 三组，接受三种不同的手术方法。A 组采取颈前路颈椎间盘切除，椎间融合器（Gage）植骨融合，椎体锁定钛板内固定术。B 组采用颈前路椎体次全切除，钛笼植骨融合，椎体锁定钛板内固定术。C组采用颈后路单开门椎管扩大成形，侧块钛板内固定术。结果85例患者全部获得随访，随访时间1年到6年，手术疗效满意，其中疗效达到优45例，良31例，可7例，差2例，优良率为89.55%。A、B、C 组优良率分别为90.00%、88.68%和91.67%。三组间术后神经功能改善优良率无明显差异（ P ﹥0.05）。结论三种手术方法治疗脊髓型颈椎病各自有其手术适应证，不能相互取代，在今后的临床工作中应严格掌握适应证，尽早实施手术可取得满意的治疗效果。
목적：대비연구척수형경추병삼충불동수술방법적림상료효。방법자2011년9월지2013년9월공수치85례척수형경추병환자，분위 A、B、C 삼조，접수삼충불동적수술방법。A 조채취경전로경추간반절제，추간융합기（Gage）식골융합，추체쇄정태판내고정술。B 조채용경전로추체차전절제，태롱식골융합，추체쇄정태판내고정술。C조채용경후로단개문추관확대성형，측괴태판내고정술。결과85례환자전부획득수방，수방시간1년도6년，수술료효만의，기중료효체도우45례，량31례，가7례，차2례，우량솔위89.55%。A、B、C 조우량솔분별위90.00%、88.68%화91.67%。삼조간술후신경공능개선우량솔무명현차이（ P ﹥0.05）。결론삼충수술방법치료척수형경추병각자유기수술괄응증，불능상호취대，재금후적림상공작중응엄격장악괄응증，진조실시수술가취득만의적치료효과。
Objective To compare the effect of three different surgical methods in treatment of patients with cervical spondylosis. Meth-ods A total of 85 patients with cervical spondylosis treated by 3 different kinds of cervical operation during the period of September 2011 to Sep-tember 2013 were divided into A,B and C groups. Patients in group A were treated by resection of cervical intervertebral disc,anterior portion in-tervertebral fusion(Gage)bone graft fusion and vertebral body locking titanium plate fixation. Patients in group B were treated by front road verte-bral body subtotal resection,anterior portion titanium cage bone graft fusion and fixation with vertebral body locking titanium plate. Patients in group C were treated by expand forming,cervical posterior single door vertebra canal side piece of titanium plate fixation. Results All 85 patients received follow - up for 1 to 6 years. Excellent result had been got in 45 cases,good in 31 cases,common in 7 cases and bad in 2 cases. The rate of satisfactory effect rate was 89. 55% . Group A,B,C the excellent rates was respectively 90. 00% ,88. 68% and 91. 67% . The difference in sat-isfactory effect rate and amelioration of nerve function among 3 groups was not statistically significant( P ﹥ 0. 05). Conclusion All these three surgical methods have their own surgical indications,and they cannot replace each other. It is important to choose good indications before operation and operation should be taken as soon as possible,then it will achieve good operation effect.